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NPI Code Detail

MEDICARE: EPIFANIO MILITAR MD

MEDICARE: EPIFANIO MILITAR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician176896NY

General Provider Information

NPI Number : 1215928353
Entity Type Code : Individual
Provider Name (Legal Business Name) : EPIFANIO MILITAR MD
Provider Business Mailing Address
First Line : PO BOX 130
Second Line :
City : LATHAM
State : NY
Zip : 12110-0130
Country : US
Telephone Number : 518-786-1291
Fax Number : 518-786-1293
Provider Business Practice Location Address
First Line : 427 GUY PARK AVE
Second Line :
City : AMSTERDAM
State : NY
Zip : 12010-1054
Country : US
Telephone Number : 518-841-7203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2005
Last Update Date : 07/08/2007

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